Pharmacotherapy of social anxiety disorder
Abstract
Over the last few years, a number of medications have demonstrated their efficacy in the acute treatment of social anxiety disorder. At present, selective serotonin reuptake inhibitors probably constitute the first line treatment, based on their safety, tolerability, and efficacy in the treatment of social anxiety disorder and common comorbid conditions. Data from single trials suggest that clonazepam, bromazepam, and gabapentin may have efficacy similar to the serotonin reuptake inhibitors, but further studies are needed to confirm these findings. The monoamine oxidase inhibitor phenelzine appears to be at least as efficacious as these other agents, but should be reserved for cases that fail to respond to these safer medications. Among the reversible inhibitors of monoamine oxidase A, brofaromine may also be an effective drug, while moclobemide appears to be less potent. Future research directions should include delineating ways to achieve remission (as opposed to response); developing strategies for augmenting partial responders and treating nonresponders to first line approaches; studying the long-term response to medication and prevention of relapse when medication is discontinued; clarifying ways to integrate psychosocial and pharmacological treatment approaches; developing predictors of which patients do best with which treatments; and the treatment of social anxiety disorder in children and adolescents.
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Only about 30% of subjects with SAD achieve true recovery or remission without residual symptomatology with currently available drugs.
“only about 30% of the subjects achieve true recovery or remission without residual symptomatology (Blanco et al, 2002)”
From Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients (2011) · cites this paper as Blanco et al, 2002
Both SSRIs and SSNRIs have an initial activation and a long latency period of response.
“However, both SSRIs and SSNRIs have an initial activation and a long latency period of response, and benzodiazepines are limited by their potential to produce motor impairment, sedation, and to induce dependence and withdrawal symptoms following discontinuation (Blanco et al, 2002).”
From Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients (2011) · cites this paper as Blanco et al, 2002
Benzodiazepines are limited by their potential to produce motor impairment, sedation, and to induce dependence and withdrawal symptoms following discontinuation.
“However, both SSRIs and SSNRIs have an initial activation and a long latency period of response, and benzodiazepines are limited by their potential to produce motor impairment, sedation, and to induce dependence and withdrawal symptoms following discontinuation (Blanco et al, 2002).”
From Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients (2011) · cites this paper as Blanco et al, 2002
Cites
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Self-citationPhenelzine vs Atenolol in Social Phobia: A Placebo-Controlled Comparison
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Self-citationThe epidemiology of social phobia: Findings from the Duke Epidemiological Catchment Area Study
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Bergamaschi, M. M., Queiroz, R. H. C., Chagas, M. H. N., de Oliveira, D. C. G., De Martinis, B. S., Kapczinski, F., Quevedo, J., Roesler, R., Schröder, N., Nardi, A. E., et al. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2011.6 · Cited by 771 · see citing works
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The treatment of social anxiety disorder
Rodebaugh, T. L., Holaway, R. M., & Heimberg, R. G. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.07.007 · Cited by 424 · see citing works
Brain oxytocin in social fear conditioning and its extinction: involvement of the lateral septum
Zoicas, I., Slattery, D. A., & Neumann, I. D. (2014) · Neuropsychopharmacology · doi:10.1038/npp.2014.156 · Cited by 189 · see citing works
Pharmacotherapy for social anxiety disorder (SAnD)
Williams, T., Hattingh, C. J., Kariuki, C. M., Tromp, S. A., van Balkom, A. J., Ipser, J. C., & Stein, D. J. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001206.pub3 · Cited by 84 · see citing works
- Authors
- Blanco, C., Antia, S. X., & Liebowitz, M. R.
- Affiliations
- New York State Psychiatric Institute (US)
- Corresponding author
- Blanco, Carlos
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2002-01
- Volume
- 51
- Issue
- 1
- Pages
- 109-120
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2050018668
- Cited by
- 88
- References
- 5
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-14155)
- National Institute on Drug Abuse (DA-00482)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- social anxiety disorder, pharmacotherapy, selective serotonin reuptake inhibitors, clonazepam, bromazepam, gabapentin, phenelzine, monoamine oxidase inhibitors, brofaromine, moclobemide, treatment response, remission, relapse prevention, comorbidities, children and adolescents
- MeSH terms
- Humans, Monoamine Oxidase Inhibitors, Phobic Disorders, Selective Serotonin Reuptake Inhibitors
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